Agenda and minutes

The Chairman extended a welcome to Members of the Board.

Apologies were received from Cllr Mrs Judith Heathcoat, Cllr Ed Turner and Peter Clark.

There were no declarations of interest submitted.

There were no requests to submit a petition or to make an address.

To approve the Note of Decisions of the meeting held on 3 March 2016                       (HBW5) and to receive information arising from them.

The note of the last meeting which took place on 3 March 2016, was approved and signed as a correct record.

2:05

15 minutes

Persons Responsible:                    Director of Public Health, Director for Adult Social Services and Director for Children’s Services, OCC; Chief Executive. OCCG

Person Co-ordinating reports:       Director of Public Health

To receive an update on performance against the outcomes in the Joint Health & Wellbeing Strategy set for 2015/16 (HWB6).

Action Required: to note the report.

The Board received an update on performance against the outcomes in the Joint Health & Wellbeing Strategy set for 2015/16.

In relation to Priority 7, Target 7.1 – ‘Reduce the number of people delayed in hospital from an average of 145 per day in 2014/15 to an average of 96 for 2015/16’, David Smith reported that performance had increased considerably since the end of Quarter 4 (153) and at the end of June the figure was at 60. He added that this was the result of all in the system working together. In response to a question about the sustainability of this, John Jackson stated that the trend was continuing to be downwards. Moreover, Oxfordshire’s performance was being observed elsewhere, for example, Simon Stevens had cited it as an example of good practice at the Chairman’s Confederation and the Royal Berkshire Hospital, at a recent Board meeting, had expressed an interest in coming to Oxfordshire to observe practice.

In relation to Priority 3, Targets 3.6 and 3.8 – ‘Reduce the assessed level of risk for high risk domestic violence victims managed through the MARAC (Multi-Agency Referral Risk Assessment Conference)’ and ‘Monitor the proportion of MASH (Multi-Agency Safeguarding Hub) enquiries leading to a referral where information was shared with partner agencies.’ – Cllr Melinda Tilley undertook to look into the possibility of raising the targets, stating that a review of MASH was underway and suggesting that it be taken to the Community Safety Partnership for discussion.

It was AGREED to note the report.

2:20

20 minutes

Person(s) responsible:                    All Partners

Person coordinating report:           Director of Public Health

Attached at HWB7 is the draft revised Joint Health & Wellbeing Strategy for 2016/17 together with the performance against outcomes in the 2015/16 Strategy. The cover report to this document sets out the process for revision and also contains the views of the Oxfordshire Joint Health Overview & Scrutiny Committee put forward at its meeting on 30 June 2016.

The Health & Wellbeing Board is RECOMMENDED to:

(a)   consider the views of the Health Overview and Scrutiny Committee, the content of the Joint Strategic Needs Assessment (which was presented to this Board in March 2016) and the performance against outcomes in the 2015-16 JHWBS in suggesting any final amendments to the document; and

(b)accept the JHWBS as the basis for its work in 2016-17.

The Board had before them for approval the draft revised Joint Health & Wellbeing Strategy for 2016/17, together with performance against outcomes in the 2015/16 Strategy.

The Board addressed the comments on the draft Strategy made by the Oxfordshire Joint Health Overview & Scrutiny Committee (HOSC) at its meeting on 30 June, with the following responses:

·         The Strategy covered a broad spectrum of services with diverse accountabilities. Its aim was to keep a broad view of the impact of the Board on the population. This was done by using measurement of population via population outcomes which were listed in the performance framework and monitored regularly. The Board was open to suggestions about how to improve this. In response to specific questions raised by members of the Oxfordshire Joint Health & Overview Committee (HOSC) about the impact of service changes, the Board reminded HOSC that since the proposed Strategy had been compiled, the Comet Bus Service had been launched and discussions had taken place with Children’s Centres and Housing Related Support. In addition, it was reported that 35 outcome measures from last year’s Strategy were showing an improvement, which showed that it was making a difference and having an impact on the population;

·         Similarly, the STP, which did not exist as yet, would include NHS system-based plans covering 3 counties. The Joint HWB Strategy was solely Oxfordshire’s document and is a population-based approach. There would be opportunity to clarify the ongoing relationship between the two strategic plans as the STP was developed, but in the meantime the need for the Joint Health & Wellbeing Strategy remained.

·         HOSC’S suggestion that it would be helpful to include a full summary of the previous year’s performance in order to more fully understand the proposal outcomes was taken on board;

·         Similarly, the comment that there was too little detail on who implemented the work to meet the outcomes, and how they were held to account, was taken on board.

·         There was no charge for the reablement service, thus the information was complete and the service was for the population as a whole.

During discussion, the Board AGREED the following actions:

(a)  more information from Public Health on the reasons why not all children were receiving meningitis inoculations;

(b)  with regard to Priority 2 ‘Narrowing the gap for our most disadvantaged and vulnerable groups’, proposed outcome 2.5 ‘Reduce the persistent absence of children subject to Child in Need and a Child Protection Plan’ – it was suggested that officers investigate if MASH could have an involvement;

(c)  there was a need to take action, without detracting from, or at the expense of the universal services,  to analyse inequality gaps; for example in outcomes for people in ethnic groups. Appropriate targets could then be set with the aim of improving outcomes for those with the worst outcomes. It was noted that the Health Improvement Board was already doing this for some areas of their work and that this should become more widespread practice across all the Partnership Boards/JMGs; and

(d)  taking  ...  view the full minutes text for item 7.

2:40

30 minutes

Person responsible:                                    Chief Executive, OCCG

Person giving report:                       Chief Executive, OCCG

There will  be a verbal update on the draft submission to NHS England (HWB8).

David Smith, Chief Executive, Oxfordshire Clinical Commissioning Group, gave a verbal update on the draft submission of the Oxfordshire’s Sustainability & Transformation Plan 2016/17 to NHS England. He gave the update in two parts, the first being ongoing work across the ‘BOB’ (Buckinghamshire, Oxfordshire and Berkshire) footprint and the second, ongoing work specifically in Oxfordshire.

With regard to the ongoing work across the BOB footprint, he reported that the draft submission had now been submitted to NHS England and he was the lead. The main priorities at this level were:

(a)  prevention – including the promoting of physical activity and the prevention of obesity;

(b)  changes to Urgent Care across the system;

(c)  capacity issues in maternity services; and

(d)  specialised commissioning.

The STP leaders, chief executives of various organisations had raised a number of issues about the proposals that needed to be worked up, one of which was of governance and how the new structures would sit with Health & Wellbeing Boards across the BOB network. NHS allocation of new funding would be made across the BOB footprint and implications for local planning were unknown. A discussion then ensued about what the Board would aspire to in order to attain the most positive benefits and the merits of an enhanced prevention agenda was agreed.

In relation to the ongoing work specifically in Oxfordshire, David Smith referred to the ‘Big Conversation’ which had just been launched, which comprised 6 public engagement events in various locations. In parallel to this, the NHS was in the process of working up detailed plans for care closer to home and how to link in community pharmacies, Social Care and the voluntary sector. Following clearance by NHS England and Central Government, the Oxfordshire Transformation Plan (the local part of the STP) would be out for consultation in the early Autumn.

Dr McWilliam spoke about the merits of enhanced levels of a ‘transformation shift to prevention across all NHS services. This needed to be a core part of the plans at both Oxfordshire and STP level if the pressures on the NHS were to be reduced and people were to have better and longer lives. This had to include NHS initiatives to embed prevention in all patients contacts and would need changes in the system to enable GPs and others to have time to devote to talking to patients about preventing illness.

Other proposals likely to be in the consultation document would include enhanced levels of primary and community care closer to home, to prevent hospital admissions,  which would enable GP surgeries, working as groups in a locality, to have access to technology and specialists. This would be supported by an agenda leading to the integration of social care and primary care. Building this up to suit the requirements of each location would require building based designs.

With regard to process, David Smith stated that as the above would be a significant change to services, the Oxfordshire Health Overview & Scrutiny Committee (HOSC) would need to be formally  ...  view the full minutes text for item 8.

3:10

10 minutes

Persons responsible:                      OCCG and OCC

Person giving report:                       Chief Executive, OCCG

To update the Board on the development and submission of Oxfordshire’s Better Care Fund Plan for 2016/17. The cover report and Plan, which has now been submitted, is attached at HWB9.

Action Required: to receive the Better Care Fund Plan for 2016-17.

John Jackson updated the Board on the development and submission of Oxfordshire’s Better Care Fund Plan for 2016/17. The cover report and plan was attached at HWB9.

The Board AGREED to receive the Better Care Fund Plan for 2016/17.

3:20

10 minutes

Persons responsible:                      OCCG

Person giving report:                       Chief Executive, OCCG

A planning template and action plan is attached at HWB10.

Sula Wiltshire, Director of Quality and Lead Nurse, OCCG, and Kate Terroni, Assistant Director for Adult Social Care introduced the planning template and Action Plan (HWB10).

John Jackson acknowledged the work done by the District Councils in supporting the move to supported living in Oxfordshire. This had enabled the development of some very creative schemes that had proved very successful for the wellbeing of the users and their families.

It was AGREED to note the Plan.

3:30

15 minutes

Person responsible:                        Healthwatch Oxfordshire (HWO)

Person giving report:           Chairman, HWO

A general update on HWO activities will be given by Eddie Duller, OBE, Chairman of HWO (HWB11).

Eddie Duller gave a general update on Healthwatch Oxfordshire’s (HWO) activities. He highlighted his concern about growing problems with patient accessibility to GPs and expressed a hope that this would be addressed as part of the Transformation Plan.

The Board welcomed the HWO report on Female Genital Mutilation, which was due to be published in early September.

In response to a request for information by a Board member on how much feedback had been received on the subject of repeat prescriptions and some reported incidences of a shortage of stock, Carol Moore, Chief Executive of HWO, stated that only two pharmacies in the south of the county had sent feedback and HWO had no additional concerns.

James Drury explained that some of the large pharmacies who gathered in prescriptions had changed their business models thus causing some issues of availability. He added that a project was being rolled out to encourage the public to use the electronic facility open to them.

The Board took the opportunity to thank Carol Moore, who was leaving the area, for all her hard work and wished her well in the future.

The Board AGREED to note the report.

3:45

10 minutes

Attached are written reports on activities since the last Health & Wellbeing Board meeting in March (HWB12) from:

·         Children’s Trust

·         Older People Joint Management Group

·         Health Improvement Partnership Board

Action Required:    to receive the reports.

The Chairmen of the Children’s Trust and the Health Improvement Partnership Board, together with the Director for Adult Social Care, presented the written reports on activities since the last full Board meeting (HWB11).

Cllr Tilley, Chairman of the Children’s Trust, highlighted that there would be a review of the Children’s Trust and its role at its next meeting. Also the new interim Chair of the Safeguarding Board was coming along.

Cllr Anna Badcock, Chairman of the Health Improvement Partnership Board, highlighted its Healthy Weight Review which, she stated, had been very well run and had resulted in some very good solutions.

The Board AGREED to note the reports.

A summary of communications received by the Chairman is attached at HWB13.

Noted.